Department of Prosthodontics, National and Kapodestrian University of Athens, Greece.
J Esthet Restor Dent. 2017 Jul 8;29(4):233-246. doi: 10.1111/jerd.12303. Epub 2017 May 27.
The problem of technical complications in implants and implant-supported restorations has existed for decades. The most frequent complication is the loosening of the fixing screw, which although is not catastrophic, if it occurs repeatedly, it may affect the success of the implant therapy and the patient satisfaction. Factors that affect the frequency of prosthetic complications include: the implant-abutment connection, para-functional habits, cantilevers, and the type of restoration. Regarding the implant-abutment connection, the first systems were those with an external hexagon. Because of their small height and the disadvantages that this entails, other connection types were developed, such as those of hexagonal and conical connection, which decreased the complication rates, including the loosening of the fixing screw. On the dilemma "cement- or screw-retained restoration", the choice depends on biological, technical, and aesthetic factors. Cement-retained restorations are simpler in construction with lower cost and clinicians are more familiar with the clinical procedure. On the other side, if the fixing screw of the abutment is loosened in a cement-retained restoration, it may be a difficult and demanding clinical task to fix this prosthetic complication. Screw-retained restorations are more prone to loosening of the fixing screw, but allow easy retrievability and repair. Their use however, is often restricted because of diverting or unfavorable inclination of the alveolar ridge and the implant. The aim of this article was to present clinical solutions for the complication of screw-loosening through clinical examples and discuss the factors that may predispose to its occurrence.
The problem of technical complications in implants and implant-supported restorations has existed for decades. The most frequent complication is the loosening of the fixing screw which, although is not catastrophic, if it occurs repeatedly, it may affect the success of the implant therapy and the patient satisfaction. Factors that affect the frequency of prosthetic complications include: the implant-abutment connection, para-functional habits, cantilevers and the type of restoration. The treatment options for the clinician are limited but certain preventing measures during construction of the restoration may be helpful to overcome this clinical problem.
几十年来，植入物和种植体支持修复体的技术并发症问题一直存在。最常见的并发症是固定螺钉松动，虽然这不太严重，但如果反复发生，可能会影响种植体治疗的成功率和患者满意度。影响修复体并发症频率的因素包括：种植体-基台连接、副功能习惯、悬臂梁和修复体类型。对于临床医生来说，治疗选择是有限的，但在修复体制作过程中采取某些预防措施可能有助于克服这一临床问题。
